Failed back surgery syndrome: casuistic and etiology

• Published in: Arquivos de neuro-psiquiatria Vol. 64; no. 3B; pp. 757 - 761
• Main Authors: Rodrigues, Flávio Freinkel, Dozza, Diego Cassol, de Oliveira, Claudio Russio, de Castro, Ricardo Gomes
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Academia Brasileira de Neurologia - ABNEURO 01.09.2006
• Subjects: Adult; Aged; Back Pain - diagnosis; Back Pain - etiology; Female; Humans; Intervertebral Disc Displacement - surgery; Laminectomy - adverse effects; Lumbar Vertebrae - surgery; Magnetic Resonance Imaging; Male; Middle Aged; NEUROSCIENCES; Postoperative Complications; PSYCHIATRY; Retrospective Studies; Spinal Stenosis - surgery; Syndrome; Tomography, X-Ray Computed; Treatment Failure; failed back surgery syndrome; lombalgia; epidural fibrosis; hérnia de disco recorrente; back pain; discectomia; estenose de canal lombar; spinal stenosis; recurrent disc herniation; síndrome pós-laminectomia; fibrose epidural; discectomy
• ISSN: 0004-282X; 1678-4227; 0004-282X
• DOI: 10.1590/S0004-282X2006000500011

To report our data of cases of failed back surgery syndrome (FBSS) and surgical and nonsurgical etiologies. The medical charts of 121 patients submitted to laminectomy, hemilaminectomy combined with discectomy and/or foraminotomy between January 1997 and October 2004 in the Instituto of Neurologia Deolindo Couto were reviewed. The inclusion criterion was does not improve or the symptoms return after the surgery and with a minimum of three medical consultations with adequate investigation for the diagnosis. The patients had been divided in three main pre-surgical diagnosis: herniated disc, lumbar stenosis and the association of these. From the 121 patients submitted to spine surgical intervention, 47 (38.8%) had presented criteria for the FBSS. Among the 26 patients who had presented operative diagnosis of lumbar stenosis, 8 (30.7%) had presented FBSS; of the 83 with disc herniation, 31 (37.3%) had the syndrome; and the 12 patients with lumbar stenosis associated with disc herniation, 7 (58.3%) had failure of the back surgery. The failure of back surgery remains a challenge for the surgeons. There is an incessant search for the causes and the action mechanisms of this syndrome and the best method of treatment.